The first pharmacist-managed anticoagulation clinic under a collaborative practice agreement in Qatar: clinical and patient-oriented outcomes

Elewa, Hazem; Abdelsamad, Osama; Elmubark, A. E.; Al-Taweel, H. M.; Mohamed, Adham; Kheir, Nadir; Ibrahim, Mohamed Izham Mohamed; Awaisu, Ahmed

doi:10.1111/jcpt.12400

Cited by 15 publications

(25 citation statements)

References 9 publications

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“…Pharmacists-led clinics also achieved low prevalence of patients with supra-therapeutic INR (5.2%11) and (16.9%) due to the low INR tests (n=53) compared to the physicians group with n=499 INR tests4, with one major bleeding event (0.67%/year) [10]. Two articles showed non-significant results (P=0.0311) and (P=0.05394) with percentages of 2.4% [4] and 5.2% [11] respectively, and Zhou's pharmacist-managed group had a non-significant Odds Ratio (OR) of 0.89 (95% CI, 0.56-1.44, P =0.64) [13].…”

Section: Supra-therapeutic Inrmentioning

confidence: 92%

“…The metaanalysis showed an OR of 0.41 (95% CI, 0.01-0.81, P=0.04) revealing a significant improvement in the pharmacistmanaged warfarin anticoagulation group [13]. Another study reported that the participants with anticoagulation treatment showed a significant high satisfaction level with anticoagulation treatment intervention (58 (44) vs. 82 (59)); P=0.009) [10].…”

Section: Patient Orientationmentioning

confidence: 96%

“…Not all the studies have included naïve participants [4,[10][11][12][13] except only one [3]. Necessary information were recorded and stated objectively (therapeutic INR, supra-therapeutic INR, and sub-therapeutic INR), and few among them have shown missing data required to standardize measurements [3,11].…”

Section: Quality Assessmentmentioning

confidence: 99%

“…Therapeutic INR: Patient following the pharmacist clinic had a "within range" INR yielding a percentage of 81.1% [3], 81.8% [11], 58.7% [4], 76.8+-22.9% [10], 57.5% [12] and shown significant [3,4,10,11,13] outcomes against the physicians managed group. In the meta-analysis, they exhibit odd ratio of 3.66 (95% CI, 2.20-5.11, P<0.00001) [13].…”

Section: Pharmacist Led Clinicmentioning

confidence: 99%

“…Patients might spend less time being in the sub-therapeutic range with pharmacist-led clinic [4]. One of the studies showed that the pharmacist had only two thromboembolic events (1.35%/y) [10], and significant (P=0.007) findings were presented in Elwa's study with a percentage of 5.2%, however Zhou showed a contrast nonsignificant findings of odd ratio (OR) 0.81 (95% CI, 0.34-1.92, P=0.64) [13].…”

Section: Sub-therapeutic Inrmentioning

confidence: 99%

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Compare the clinical management of warfarin among physician versus pharmacist-led coagulation clinic: structured systematic review

Gillani¹,

Alsubaihi²,

Zaghloul³

et al. 2018

biomedicalresearch

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The aim of the study was to assess the management of INR therapeutic range as an estimate for achieving therapeutic outcome and estimate sub/supra-therapeutic INR's among physician versus pharmacist-led clinics. Articles were searched in: PubMed, Cochrane, Springer, Science Direct, and Wiley. The search was limited to the English language from 2010 to 2016. The inclusion criteria of the articles keywords such as warfarin, management, pharmacist, physician, therapy, clinic, and anticoagulation were used and GRACE guideline was used to assess the quality of these research articles. A total of 1050 articles were found with the relative subject, after excluding the duplicates more than 50% have been excluded, following the title and reviewing the abstract another 133 (12.67%) were ruled out, and 6 studies were included in the systematic review. In multiple studies pharmacist-Led coagulant clinic showed better outcomes with warfarin anticoagulant therapy. Patients exhibits high satisfaction levels and least warfarin induced complications in comparison with those results obtained with physician-led clinic. It is found that patients-oriented care has not been reported in the retrieved literature, which might open a room for researcher to determine the impact of services provided by pharmacists on individual patient-centered outcomes.

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Section: Supra-therapeutic Inrmentioning

confidence: 92%

Section: Patient Orientationmentioning

confidence: 96%

Section: Quality Assessmentmentioning

confidence: 99%

Section: Pharmacist Led Clinicmentioning

confidence: 99%

Section: Sub-therapeutic Inrmentioning

confidence: 99%

See 3 more Smart Citations

Compare the clinical management of warfarin among physician versus pharmacist-led coagulation clinic: structured systematic review

Gillani¹,

Alsubaihi²,

Zaghloul³

et al. 2018

biomedicalresearch

View full text Add to dashboard Cite

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Perspectives of practising pharmacists towards interprofessional education and collaborative practice in Qatar

et al. 2018

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Background Healthcare is provided by a variety of different professionals, including pharmacists who are integral members of the team, and all are expected to work collaboratively to provide quality care. Little is known about the perceptions of pharmacists in Qatar towards interprofessional collaboration. Positive attitudes towards interprofessional education are essential to successful implementation of interprofessional collaboration. Therefore, to develop effective collaboration strategies in practice settings, it was essential to survey the attitudes of practising pharmacists towards collaboration. Objective To explore the awareness, views, attitudes and perceptions of practising pharmacists in Qatar towards interprofessional education and collaborative practice. Setting Community, hospital and primary healthcare settings in Qatar. Methods This was a two-staged sequential explanatory mixed method design. It utilised a quantitative survey (Stage 1), based on a modified version of the Readiness for Interprofessional Learning Scale. This was followed by a qualitative stage, utilising focus groups (Stage 2). Main outcome measures (1) Qatar pharmacists' attitudes towards interprofessional education and collaborative practice; (2) Practising pharmacists' perspectives in relation to enablers, barriers and recommendations regarding interprofessional education and collaborative practice. Results 63% of the practising pharmacists (n = 178) responded to the survey. Three focus groups followed (total n = 14). High scores indicating readiness and positive attitudes towards interprofessional education were reported for pharmacists working in hospital, community and primary healthcare settings. Qualitative analysis identified three overarching themes in relation to the enablers, barriers and recommendations for practising pharmacists working collaboratively. The enabling themes were: professional and patient related benefits, and current positive influences in Qatar; the barriers were patients' negative perceptions; the status of the pharmacy profession and current working practices and processes; the recommendations related to improving patients' perceptions about pharmacists and enhancing the status of pharmacy profession in Qatar. The findings from this study highlighted two major observations: the lack of existence of collaborative practice and hierarchy and power play. Conclusion Pharmacists demonstrated willingness and readiness to develop interprofessional learning and collaborative practice with significant steps already taken towards improving collaborative working practices in different care settings.

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Patient satisfaction with community pharmacist-led anticoagulation management services and its relationship with patient characteristics in New Zealand

et al. 2020

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Background: Community pharmacist-led anticoagulation management service (CPAMS) offers international normalised ratio point-of-care testing of warfarin in a community pharmacy setting. It has now expanded with 7,344 patients enrolled in the service across 164 pharmacies in New Zealand. The clinical benefit of CPAMS has been shown to be superior, but patient satisfaction with the service has not been fully explored.Objective: To develop a questionnaire to assess patient satisfaction with CPAMS and evaluate its psychometric properties. Additionally, to determine the level of patient satisfaction with CPAMS and identify determinants of satisfaction with CPAMS.Settings: 1071 patients enrolled in CPAMS across New Zealand took part in the study Main outcome measure: Satisfaction with CPAMS service Methods: Adult patients taking warfarin and currently enrolled in CPAMS were recruited through the national international normalised ratio online system and invited to complete a 36item survey assessing satisfaction with CPAMS. To identify the most important dimensions of patient satisfaction, exploratory factor analysis was used. Multivariate linear regression models were used to examine the effect of independent variables on patient satisfaction.Results: A total of 305 patients completed the survey. The mean overall satisfaction score was 94.5% ± 13.1 out of maximum possible points. Five dimensions of patient satisfaction were identified by factor analysis: patient-centred communication, confidence in pharmacist competence, patient-pharmacist relationship, confidence in CPAMS, and pharmacy environment. Being older and more frequent visits to the pharmacy were positively associated with patient satisfaction. Living more than 1km away from a pharmacy, and 'poor' selfperceived health status were negative predictors of patient satisfaction. Being Māori or of other ethnic minority was also associated with lower satisfaction scores, exploratory analysis suggests patient-pharmacist relationship is an important driver of these differences. Conclusions:The high level of patient satisfaction further supports the effectiveness of CPAMS as a delivery model. Patient satisfaction is affected by age, frequency of pharmacy visits, ethnicity, travel distance to pharmacy, and perceived health status. Policy makers and

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The first pharmacist-managed anticoagulation clinic under a collaborative practice agreement in Qatar: clinical and patient-oriented outcomes

Abstract: These findings provide early evidence that the patients who were managed at a pharmacy-based anticoagulation clinic in an evolving healthcare system experienced optimal anticoagulation management.

Cited by 15 publications

References 9 publications

Compare the clinical management of warfarin among physician versus pharmacist-led coagulation clinic: structured systematic review

Compare the clinical management of warfarin among physician versus pharmacist-led coagulation clinic: structured systematic review

Perspectives of practising pharmacists towards interprofessional education and collaborative practice in Qatar

Patient satisfaction with community pharmacist-led anticoagulation management services and its relationship with patient characteristics in New Zealand

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